| Oleg B. Shpak, MD, PA | |
|
9470 Annapolis Rd Suite 210 Lanham MD 20706-3025 | |
| (301) 577-5511 | |
| (301) 577-1177 |
| Full Name | Oleg B. Shpak, MD, PA |
|---|---|
| Speciality | Clinic/Center |
| Location | 9470 Annapolis Rd, Lanham, Maryland |
| Authorized Official Name and Position | Oleg B. Shpak (OWNER) |
| Authorized Official Contact | 3015775511 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Oleg B. Shpak, MD, PA 9470 Annapolis Rd Suite 210 Lanham MD 20706-3025 Ph: (301) 577-5511 | Oleg B. Shpak, MD, PA 9470 Annapolis Rd Suite 210 Lanham MD 20706-3025 Ph: (301) 577-5511 |
| NPI Number | 1316068083 |
|---|---|
| Provider Enumeration Date | 04/02/2007 |
| Last Update Date | 06/23/2017 |
| Medicare PECOS PAC ID | 9335304369 |
|---|---|
| Medicare Enrollment ID | O20120626000130 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316068083 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | () | Primary |
| Provider Name | Oleg B Shpak |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376546069 PECOS PAC ID: 4284802075 Enrollment ID: I20110721000676 |
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